The Affordable Care Act: A Reassessment

According to the Centers for Medicare and Medicaid Services (CMS) websites most recent reporting, the total outstanding net total national health expenditures, for the country, was projected to be in excess of 2.7 trillion dollars in the fiscal year(FY 14’) ending 2013. The boom in healthcare cost since the eighties has gone from manageable to encumbering for the country writ large. And though some of the countries regions contribute more than others, this is a matter of national debt not municipal, meaning that we all bear the burden of many years of neglect of the trust funds of the social safety nets. There must be a better way. This article attempts to chart that better way.

Paying Down the Debt

I know that this first one seems obvious but it must be talked about. By paying down the national debt, healthcare bills in specific, we can decrease not only the price of future bills, by lowering inflation. When inflation is low everything cost less from doctor’s visits, to medicine, to even purchasing private insurance. This added benefit to paying off the medical bills only concusses through the rest of the government as there is then less bureaucracy required to function Medicare and Medicaid which in the end saves the tax payer money. But by also doing so we allow recourse for doctors to purchase affordable malpractice insurance that allows for doctors, especially specialist to practice medicine in exurban parts of the country, like Madison county Iowa for example. This brings me to my next idea: tort reform.

Tort Reform

I know this idea has rankled most Democrats in the past, but tort reform, or lack thereof is one of the main hindrances to having a pliable and solvent public healthcare system. The idea for doctors that if you make a mistake on the operating table you won’t lose your medical license, but will instead be priced out of your profession of choice due to the high cost of medical insurance expenditures, Is simply mortifying. In fact right here in my community of Chicago, Illinois there are doctors right now who are fleeing the state due to the high cost of medical malpractice insurance. And this isn’t an isolated case. In states like Iowa and Wyoming some counties don’t even have an OBGYN. And its not for lack of expertise, or demand for that matter. But instead it all comes down to the economics of Insurance and coverage. Because you see if we’re not paying the Medicare and Medicaid bills that we receive from these doctors it won’t be long before they go out of business and have to transfer to a more densely populated part of the state or country for that matter. This to me is unacceptable… now I won’t go into much detail about how we should go about tort reform but I urge all Senators in the Senate of The United States to take up this cause and see to it that women, infants, and children; at the very least are able to be provided for in their own communities.

Drug Patents

Too often we find in this country that senior citizens and the disabled have to choose between purchasing their life saving medications or buying groceries for the week. The way in which the government goes about resolving this problem is noble but flawed. By purchasing the medicines at a price that the drug companies along with the insurance companies set (Medicare Part D) we almost guarantee that the patent will run much longer than its intended time vis a vis multiple versions of the same drug coming out, this I why I call on the U.S. government to cut out the middle man entirely. The National Institutes of Health (NIH) should have it in their authority the ability to purchase drug patents directly from the drug companies. By doing so we could then increase the quota of the Centers for Disease Control (CDC) so that they’re not only manufacturing drugs but also husbanding their enormous wealth of resources to patent new drugs which will prevent and even cure some diseases. Even If we only buy new patents or produce older ones, this would mark (according to the CMS) a nearly 10% decrease (> $263 billion) in the total amount of debt that the U.S. holds in national health expenditures. This was an important aspect that I feel the Affordable Care Act (ACA) punted to my generation or my children’s generation to fix.

Public to Private Hospital Ratio

This subject has been debated since at least the mid nineties so I’ll spend very little time speaking about it. Only after all the above things have been done would I recommend that the ratio of public to private hospitals be set a 60% public, and 40% private, once everything stated above is implemented, it would make sense to have mostly public hospitals, since we’d be able to offer a superior service at a competitive price. This is not to say that I don’t believe in insurance that you would be able to transfer from job to job… which brings me to my final point.

Medical Vouchers for Private care at Private Hospitals

This hotly debated point is something that I think would work great. Where there is expertise lacking in a particular area, or if your local hospital(s) doesn’t have the specific type of surgery or care that you need I would fully endorse the idea of being able to receive a voucher from the government to get treatment, or cured at a private hospital. This option only becomes affordable once everything that I have stated above has occurred, since by their very definition private hospital are more expensive than their publicly run counterparts. It would behoove the government to send someone to a private hospital when necessary an order to cure the individual which in the long run saves the government money. This is in no way meant to denigrate the extraordinary care in public hospitals, however if they are unable to provide proper treatment to a consumer, then it only makes sense that the consumer should be sent somewhere where they can be cured since someone is worth more to the state healthy and alive than chronically sick or worse.

The healthcare system was not broken over night and it will take many steps to fix and ameliorate it. These that I have laid out should act as a rough draft of Republican led legislation that will allow for a more productive, a more cost efficient, and fairer system of health governance in the country not on any other countries terms, but on our terms for our consumers, exclusively.